Public Private Partnership
Handwashing Initiative
FOAMFrom
Development
to Practice
Overview of Presentation
The Need for a Model
How FOAM was developed
How FOAM has been used
How PPPHWI fits within WSP
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A Model for HW BC
Many tools available
All stress audience-centered
programming
Lack of holistic model to explain all
factors influencing HW
Global Scaling Up HW Project presents
an opportunity
Learning objective
Common framework
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Development of a BCM for HW
 Hanoi Vietnam April 24-27, 2007
 Participants included HW Coordinators,
MoH and Global WSP team
 Facilitated by a communication consultant
 Key output: a behavior change model for
the “Scaling up HW Behavior Change”
project
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What is a behavior change
framework?
A behavior change framework is a
diagram that represents all the
various determinants of a behavior
that is desirable for a public health
outcome to occur:
 use of a condom with a commercial sex partner;
 sleeping under an insecticide-treated mosquito net to
prevent malaria;
 hand washing with soap after defecation to prevent
diarrheal diseases.
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What are determinants
of behavior?
Determinants of behavior are factors
that influence whether a person is
likely to engage in a certain behavior:
 Socio-demographic (such as age, sex and
education) or mutable (such as awareness or
understanding of a health issue)
 Internal (eg. beliefs)
 External (eg. social norms)
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What is a BC Model
Diagram that represents the various
“determinants” of behavior change
 “Determinants” are internal or external factors
that influence an individual to perform a
behavior
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Advantages of a BC Model
Provides a common language
Can help identify critical linkages
Informs M&E
Enables comprehensive, evidencebased programming
Can be adapted across populations
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Example 1: World Bank BC
Continuum
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Example 2: PSI’s PERFORM
HEALTH STATUS
QUALITY OF LIFE
USE
RISK -REDUCING BEHAVIOR
AT RISK
OPPORTUNITY
Availability
Brand
Attributes
ABILITY
Brand Appeal
Knowledge
Quality of Care
Social Norm
MOTIVATION
Belief
Attitudes
Social Support
Intention
Self Efficacy
Subjective
Norm
Locus of
Control
Outcome
Expectation
Threat
Willingness to
Pay
POPULATION CHARACTERISTICS
SOCIAL MARKETING INTERVENTION
PRODUCT
PLACE
PRICE
PROMOTION
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F in FOAM
 Focus:
desired behavior
target populations
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OAM
 Opportunity: institutional or structural
factors that influence an individual’s
chance to perform a behavior (external)
 Ability: individual’s skills and proficiency
to perform a behavior
(internal)
 Motivation: drives, wishes, urges, or
desires that influence an individual to
perform a behavior (internal)
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FOAM
Focus
Target
Audience
Desired
Behavior
Opportunity
Access/
Availability
Product
attributes
Ability
Motivation
Knowledge
Attitudes/
Beliefs
Social support
Expectations
Threat
Social norms
Intention
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From Model to Practice
Enables full marketing mix vision
FOAM can be integrated into existing tools
and frameworks (ie Trigger workshops)
FOAM can be applied to:
 Analysis of research
 Formulation of communication objectives for mass
media and IPC
 Monitoring & Evaluation
 FOAM Operational Matrix (FOM) for program
planning
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FOAM’s can compliment other
models
Steps of Change
See Handout
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FOAM’s Applications
Foam Workshop
Used FOAM to
analyze main
findings from VN
HW formative
research
results
Developed three key
Communication
Objectives for HW
program
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FOAM’s Applications
con’t
Agency Brief
See handout
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FOAM Tour 2007
 Hanoi – Initial FOAM workshop
 Dakar – Presentation to global
WSP team
 Washington DC – input from
Tech. working group on BC
 Lima – Reanalysis of previous
research
 Hanoi – National FOAM
workshop
 Washington DC – Finalize
FOAM tools
 Dar es Salaam – National FOAM
workshop
 Senegal – Doer, Nondoer study
 Kenya – FOAM workshop
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WSP’s Other Support Activities
Vietnam
 Sanitation and Water Partnership for the Mekong
Region (SAWAP) is an multi-country technical
assistance program in sanitation, hygiene and
water supply sectors
 Supporting the VN Gov to develop a Unified Sanitation
Strategy
 Updating the Rural Water Supply & Sanitation Strategy
 Study of domestic private sector participation in water supply
and sanitation services
 Benchmarking study to measure and monitor performance of
urban water utility service providers
Regionally

EASAN to increase GoV commitment to sanitation in 2008
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Thank you!
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